Details of the Drug

General Information of Drug (ID: DMB08GE)

• Drug Name: Sulfamethoxazole
• Synonyms: sulfamethoxazole; 723-46-6; Gantanol; Sulphamethoxazole; Sulfisomezole; Sulfamethoxazol; Metoxal; Sulfamethylisoxazole; Simsinomin; Radonil; Sinomin; Sulphamethoxazol; 4-Amino-N-(5-methyl-3-isoxazolyl)benzenesulfonamide; Sulpha-methoxizole; Sulfamethalazole; Azo-gantanol; Sulphamethylisoxazole; Urobak; Sulfamethoxizole; 3-Sulfanilamido-5-methylisoxazole; Gantanol-DS; 4-amino-N-(5-methylisoxazol-3-yl)benzenesulfonamide; Bactrimel; Gamazole; Sulphisomezole; Sulfametoxazol; Solfametossazolo; Sulfamethoxazolum; Ro 4-2130; SMX; Septran; Sulphamethalazole; Trib; Solfametossazolo [DCIT]; Sulfamethoxazole sodium; MS 53; Sulphamethoxazole BP 98; ALBB-002089; Apo-Sulfamethoxazole; Bactrim (TN); Septra (TN); Septrin (TN); Sulfamethoxazolum [INN-Latin]; Sulfametoxazol [INN-Spanish]; Ro 6-2580/11; Ro-4-2130; Sulfamethoxazole [USAN:INN:JAN]; Sulfamethoxazole (JP15/USP/INN); N1-(5-Methyl-3-isoxazolyl)sulfanilamide; N1-(5-Methylisoxazol-3-yl)sulfanilamide; SULFAMETHOXAZOLE (8064-90-2 (TRIMETHOPRIM/SULFAMETHOXAZOLE); N'-(5-Methyl-3-isoxazole)sulfanilamide; N'-(5-Methyl-3-isoxazolyl)sulfanilamide; N'-(5-Methylisoxazol-3-yl)sulphanilamide; N(sup 1)-(5-Methyl-3-isoxazolyl)sulfanilamide; N(sup 1)-(5-Methyl-3-isoxazolyl)sulphanilamide; N(sup1)-(5-Methyl-3-isoxazolyl)sulfanilamide; Sulfanilamide, N1-(5-methyl-3-isoxazolyl)-(8CI); 3-(p-Aminophenylsulfonamido)-5-methylisoxazole; 3-(para-Aminophenylsulphonamido)-5-methylisoxazole; 3-Sulphanilamido-5-methylisoxazole; 4-Amino-N-(5-methyl-isoxazol-3-yl)-benzenesulfonamide; 4-Amino-N-[5-methyl-3-isoxazolyl]benzenesulfonamide; 4-amino-N-(5-methyl-1,2-oxazol-3-yl)benzenesulfonamide; 5-Methyl-3-sulfanilamidoisoxazole; 5-Methyl-3-sulfanylamidoisoxazole; 5-Methyl-3-sulphanil-amidoisoxazole; Sulphameth oxazole

Indication

Disease Entry	ICD 11	Status	REF
Acute otitis media	AB00	Approved	[1]
Bacillary dysentery	1A02	Approved	[1]
Bacterial infection	1A00-1C4Z	Approved	[2]
Inclusion conjunctivitis	N.A.	Approved	[1]
Pneumocystis pneumonia	CA40.20	Approved	[1]
Tuberculosis	1B10-1B14	Approved	[1]
Infection of P. falciparum	1F40	Investigative	[3]

• Therapeutic Class: Antiinfective Agents
• Affected Organisms: Haemophilus influenzaeNeisseria gonorrhoeaeKlebsiella spp.Enterobacter aerogenesProteus mirabilisProteus vulgarisShigellaVibrio choleraeStreptococcus pyogenesStreptococcus viridansStaphylococcus aureusStaphylococcus epidermidisStreptococcus pneumoniaePneumocystis cariniiEscherichia coliSalmonella spp.Brucella melitensisNocardia asteroidesNocardia brasiliensisParacoccidioides brasiliensisStreptomyces somaliensisMorganella morganii
• ATC Code:
  J01EC01: Sulfamethoxazole
  J01EC: Intermediate-acting sulfonamides
  J01E: SULFONAMIDES AND TRIMETHOPRIM
  J01: ANTIBACTERIALS FOR SYSTEMIC USE
  J: ANTIINFECTIVES FOR SYSTEMIC USE
  J01ED06: Sulfamethoxazole
  J01ED: Long-acting sulfonamides
  J01E: SULFONAMIDES AND TRIMETHOPRIM
  J01: ANTIBACTERIALS FOR SYSTEMIC USE
  J: ANTIINFECTIVES FOR SYSTEMIC USE
• Drug Type: Small molecular drug
• #Ro5 Violations (Lipinski): 0:
  Molecular Weight (mw); 253.28
  Logarithm of the Partition Coefficient (xlogp); 0.9
  Rotatable Bond Count (rotbonds); 3
  Hydrogen Bond Donor Count (hbonddonor); 2
  Hydrogen Bond Acceptor Count (hbondacc); 6
• ADMET Property:
  Absorption Cmax: The maximum plasma concentration (Cmax) of drug is 57.4-68.0 mg/L [4]
  Absorption Tmax: The time to maximum plasma concentration (Tmax) is 1-4 h [4]
  BDDCS Class: Biopharmaceutics Drug Disposition Classification System (BDDCS) Class 2: low solubility and high permeability [5]
  Bioavailability: The bioavailability of drug is 85-90% [4]
  Clearance: The renal clearance of drug is 0.22 +/- 0.05 L/h [6]
  Elimination: Approximately 84.5% of a single oral dose of sulfamethoxazole is recovered in the urine within 72 hours, of which ~30% is free sulfamethoxazole and the remainder is the N4-acetylated metabolite [7]
  Half-life: The concentration or amount of drug in body reduced by one-half in 10 hours [7]
  Metabolism: The drug is metabolized via the arylamine N-acetyltransferase (NAT) enzymes, which are responsible for acetylation of sulfamethoxazole at its N4 position [7]
  MRTD: The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 394.82001 micromolar/kg/day [8]
  Unbound Fraction: The unbound fraction of drug in plasma is 0.23% [9]
  Vd: The volume of distribution (Vd) of drug is 13 L [4]
  Water Solubility: The ability of drug to dissolve in water is measured as 0.392 mg/mL [5]

Adverse Drug Reaction (ADR)

ADR Term	Variation	Related DOT	DOT ID	REF
Agranulocytosis	Not Available	MPO	OTOOXLIN	[10]
Agranulocytosis	Not Available	ALB	OTVMM513	[10]

• Chemical Identifiers:
  Formula: C10H11N3O3S
  IUPAC Name: 4-amino-N-(5-methyl-1,2-oxazol-3-yl)benzenesulfonamide
  Canonical SMILES: CC1=CC(=NO1)NS(=O)(=O)C2=CC=C(C=C2)N
  InChI: InChI=1S/C10H11N3O3S/c1-7-6-10(12-16-7)13-17(14,15)9-4-2-8(11)3-5-9/h2-6H,11H2,1H3,(H,12,13)
  InChIKey: JLKIGFTWXXRPMT-UHFFFAOYSA-N
• Cross-matching ID:
  PubChem CID: 5329
  ChEBI ID: CHEBI:9332
  CAS Number: 723-46-6
  UNII: JE42381TNV
  DrugBank ID: DB01015
  TTD ID: D0R9OH
  VARIDT ID: DR01206
  INTEDE ID: DR1511
• Repurposed Drugs (RPD): Click to Jump to the Detailed RPD Information of This Drug

Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
Bacterial Dihydropteroate synthetase (Bact folP)	TT4ILYC	DHPS_ECOLI	Inhibitor	[11]

Drug-Metabolizing Enzyme (DME)

DME Name	DME ID	UniProt ID	MOA	REF
Cytochrome P450 3A4 (CYP3A4)	DE4LYSA	CP3A4_HUMAN	Substrate	[12]
Cytochrome P450 2C9 (CYP2C9)	DE5IED8	CP2C9_HUMAN	Substrate	[13]
Cytochrome P450 2C8 (CYP2C8)	DES5XRU	CP2C8_HUMAN	Substrate	[14]
Prostaglandin G/H synthase 1 (COX-1)	DE073H6	PGH1_HUMAN	Substrate	[15]
UDP-glucuronosyltransferase 1A9 (UGT1A9)	DE85D2P	UD19_HUMAN	Substrate	[15]
RNA cytidine acetyltransferase (hALP) Main DME	DEZV4AP	NAT10_HUMAN	Substrate	[16]

Drug Off-Target (DOT)

DOT Name	DOT ID	UniProt ID	Interaction	REF
Albumin (ALB)	OTVMM513	ALBU_HUMAN	Drug Response	[10]
Arylamine N-acetyltransferase 2 (NAT2)	OTBPDQOY	ARY2_HUMAN	Regulation of Drug Effects	[17]
Bile salt export pump (ABCB11)	OTRU7THO	ABCBB_HUMAN	Gene/Protein Processing	[18]
HLA class I histocompatibility antigen, alpha chain G (HLA-G)	OTMLK1KN	HLAG_HUMAN	Gene/Protein Processing	[19]
Interleukin-8 (CXCL8)	OTS7T5VH	IL8_HUMAN	Protein Interaction/Cellular Processes	[20]
Myeloperoxidase (MPO)	OTOOXLIN	PERM_HUMAN	Drug Response	[10]
Phytanoyl-CoA dioxygenase, peroxisomal (PHYH)	OTUG4BWA	PAHX_HUMAN	Gene/Protein Processing	[21]
Pirin (PIR)	OT8ALXHU	PIR_HUMAN	Gene/Protein Processing	[20]

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Same Disease as Sulfamethoxazole

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Disease	REF
Ofloxacin	DM0VQN3	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Ofloxacin.	Bacterial infection [1A00-1C4Z]	[22]
Clarithromycin	DM4M1SG	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Clarithromycin.	Bacterial infection [1A00-1C4Z]	[22]
Sparfloxacin	DMB4HCT	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Sparfloxacin.	Bacterial infection [1A00-1C4Z]	[22]
Gemifloxacin	DMHT34O	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Gemifloxacin.	Bacterial infection [1A00-1C4Z]	[22]
Norfloxacin	DMIZ6W2	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Norfloxacin.	Bacterial infection [1A00-1C4Z]	[22]
Levofloxacin	DMS60RB	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Levofloxacin.	Bacterial infection [1A00-1C4Z]	[22]

Coadministration of a Drug Treating the Disease Different from Sulfamethoxazole (Comorbidity)

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Remdesivir	DMBFZ6L	Moderate	Increased risk of hepatotoxicity by the combination of Sulfamethoxazole and Remdesivir.	1D6YCoronavirus Disease 2019 [1D6YCoronavirus Disease 2019]	[23]
Glibenclamide	DM8JXPZ	Moderate	Increased risk of hypoglycemia by the combination of Sulfamethoxazole and Glibenclamide.	Acute diabete complication [5A2Y]	[24]
Insulin-glulisine	DMQI0FU	Moderate	Increased risk of hypoglycemia by the combination of Sulfamethoxazole and Insulin-glulisine.	Acute diabete complication [5A2Y]	[24]
Insulin-aspart	DMX7V28	Moderate	Increased risk of hypoglycemia by the combination of Sulfamethoxazole and Insulin-aspart.	Acute diabete complication [5A2Y]	[25]
Glipizide	DMZA5PQ	Moderate	Increased risk of hypoglycemia by the combination of Sulfamethoxazole and Glipizide.	Acute diabete complication [5A2Y]	[24]
Ivosidenib	DM8S6T7	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Ivosidenib.	Acute myeloid leukaemia [2A60]	[22]
Midostaurin	DMI6E0R	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Midostaurin.	Acute myeloid leukaemia [2A60]	[22]
Idarubicin	DMM0XGL	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Idarubicin.	Acute myeloid leukaemia [2A60]	[22]
Arn-509	DMT81LZ	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Arn-509.	Acute myeloid leukaemia [2A60]	[22]
Gilteritinib	DMTI0ZO	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Gilteritinib.	Acute myeloid leukaemia [2A60]	[22]
Oliceridine	DM6MDCF	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Oliceridine.	Acute pain [MG31]	[22]
Bepridil	DM0RKS4	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Bepridil.	Angina pectoris [BA40]	[22]
Dronedarone	DMA8FS5	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Dronedarone.	Angina pectoris [BA40]	[22]
Bedaquiline	DM3906J	Moderate	Increased risk of hepatotoxicity by the combination of Sulfamethoxazole and Bedaquiline.	Antimicrobial drug resistance [MG50-MG52]	[26]
Cilostazol	DMZMSCT	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Cilostazol.	Arterial occlusive disease [BD40]	[22]
Posaconazole	DMUL5EW	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Posaconazole.	Aspergillosis [1F20]	[22]
Lisdexamfetamine	DM6W8V5	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Lisdexamfetamine.	Attention deficit hyperactivity disorder [6A05]	[22]
Desipramine	DMT2FDC	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Desipramine.	Attention deficit hyperactivity disorder [6A05]	[22]
Retigabine	DMGNYIH	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Retigabine.	Behcet disease [4A62]	[22]
Pexidartinib	DMS2J0Z	Major	Increased risk of hepatotoxicity by the combination of Sulfamethoxazole and Pexidartinib.	Bone/articular cartilage neoplasm [2F7B]	[27]
Eribulin	DM1DX4Q	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Eribulin.	Breast cancer [2C60-2C6Y]	[22]
Lapatinib	DM3BH1Y	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Lapatinib.	Breast cancer [2C60-2C6Y]	[22]
Alpelisib	DMEXMYK	Moderate	Increased metabolism of Sulfamethoxazole caused by Alpelisib mediated induction of CYP450 enzyme.	Breast cancer [2C60-2C6Y]	[28]
Bosutinib	DMTI8YE	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Bosutinib.	Breast cancer [2C60-2C6Y]	[22]
PF-04449913	DMSB068	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and PF-04449913.	Chronic myelomonocytic leukaemia [2A40]	[22]
Olodaterol	DM62B78	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Olodaterol.	Chronic obstructive pulmonary disease [CA22]	[22]
Anisindione	DM2C48U	Major	Decreased metabolism of Sulfamethoxazole caused by Anisindione mediated inhibition of CYP450 enzyme.	Coagulation defect [3B10]	[29]
Halothane	DM80OZ5	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Halothane.	Corneal disease [9A76-9A78]	[22]
Sevoflurane	DMC9O43	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Sevoflurane.	Corneal disease [9A76-9A78]	[22]
Probucol	DMVZQ2M	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Probucol.	Coronary atherosclerosis [BA80]	[22]
Mycophenolic acid	DMRBMAU	Moderate	Altered absorption of Sulfamethoxazole due to GI flora changes caused by Mycophenolic acid.	Crohn disease [DD70]	[30]
Pasireotide	DMHM7JS	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Pasireotide.	Cushing syndrome [5A70]	[22]
Osilodrostat	DMIJC9X	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Osilodrostat.	Cushing syndrome [5A70]	[22]
Ivacaftor	DMZC1HS	Moderate	Decreased metabolism of Sulfamethoxazole caused by Ivacaftor mediated inhibition of CYP450 enzyme.	Cystic fibrosis [CA25]	[31]
Sertraline	DM0FB1J	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Sertraline.	Depression [6A70-6A7Z]	[22]
Escitalopram	DMFK9HG	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Escitalopram.	Depression [6A70-6A7Z]	[22]
Clomipramine	DMINRKW	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Clomipramine.	Depression [6A70-6A7Z]	[22]
Doxepin	DMPI98T	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Doxepin.	Depression [6A70-6A7Z]	[22]
Tetrabenazine	DMYWQ0O	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Tetrabenazine.	Dissociative neurological symptom disorder [6B60]	[22]
Deutetrabenazine	DMUPFLI	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Deutetrabenazine.	Dystonic disorder [8A02]	[22]
Ingrezza	DMVPLNC	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Ingrezza.	Dystonic disorder [8A02]	[22]
Cannabidiol	DM0659E	Moderate	Increased risk of hepatotoxicity by the combination of Sulfamethoxazole and Cannabidiol.	Epileptic encephalopathy [8A62]	[32]
Solifenacin	DMG592Q	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Solifenacin.	Functional bladder disorder [GC50]	[22]
Ketoconazole	DMPZI3Q	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Ketoconazole.	Fungal infection [1F29-1F2F]	[22]
Sunitinib	DMCBJSR	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Sunitinib.	Gastrointestinal stromal tumour [2B5B]	[22]
Brentuximab vedotin	DMWLC57	Moderate	Increased risk of hepatotoxicity by the combination of Sulfamethoxazole and Brentuximab vedotin.	Hodgkin lymphoma [2B30]	[33]
Saquinavir	DMG814N	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Saquinavir.	Human immunodeficiency virus disease [1C60-1C62]	[22]
Etravirine	DMGV8QU	Moderate	Decreased metabolism of Sulfamethoxazole caused by Etravirine mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[34]
Rilpivirine	DMJ0QOW	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Rilpivirine.	Human immunodeficiency virus disease [1C60-1C62]	[22]
Fenofibrate	DMFKXDY	Moderate	Decreased metabolism of Sulfamethoxazole caused by Fenofibrate mediated inhibition of CYP450 enzyme.	Hyper-lipoproteinaemia [5C80]	[23]
Mipomersen	DMGSRN1	Major	Increased risk of hepatotoxicity by the combination of Sulfamethoxazole and Mipomersen.	Hyper-lipoproteinaemia [5C80]	[35]
BMS-201038	DMQTAGO	Major	Increased risk of hepatotoxicity by the combination of Sulfamethoxazole and BMS-201038.	Hyper-lipoproteinaemia [5C80]	[36]
Givosiran	DM5PFIJ	Moderate	Increased risk of nephrotoxicity by the combination of Sulfamethoxazole and Givosiran.	Inborn porphyrin/heme metabolism error [5C58]	[23]
Lesinurad	DMUR64T	Moderate	Decreased metabolism of Sulfamethoxazole caused by Lesinurad mediated inhibition of CYP450 enzyme.	Inborn purine/pyrimidine/nucleotide metabolism error [5C55]	[37]
Crizotinib	DM4F29C	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Crizotinib.	Lung cancer [2C25]	[22]
Ceritinib	DMB920Z	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Ceritinib.	Lung cancer [2C25]	[22]
PF-06463922	DMKM7EW	Moderate	Increased metabolism of Sulfamethoxazole caused by PF-06463922 mediated induction of CYP450 enzyme.	Lung cancer [2C25]	[23]
Osimertinib	DMRJLAT	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Osimertinib.	Lung cancer [2C25]	[22]
Selpercatinib	DMZR15V	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Selpercatinib.	Lung cancer [2C25]	[22]
Lumefantrine	DM29GAD	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Lumefantrine.	Malaria [1F40-1F45]	[22]
Halofantrine	DMOMK1V	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Halofantrine.	Malaria [1F40-1F45]	[22]
Hydroxychloroquine	DMSIVND	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Hydroxychloroquine.	Malaria [1F40-1F45]	[22]
Primaquine	DMWQ16I	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Primaquine.	Malaria [1F40-1F45]	[22]
Inotuzumab ozogamicin	DMAC130	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Inotuzumab ozogamicin.	Malignant haematopoietic neoplasm [2B33]	[22]
Calaspargase pegol	DMQZBXI	Moderate	Increased risk of hepatotoxicity by the combination of Sulfamethoxazole and Calaspargase pegol.	Malignant haematopoietic neoplasm [2B33]	[38]
Idelalisib	DM602WT	Moderate	Increased risk of hepatotoxicity by the combination of Sulfamethoxazole and Idelalisib.	Mature B-cell leukaemia [2A82]	[39]
Arsenic trioxide	DM61TA4	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Arsenic trioxide.	Mature B-cell lymphoma [2A85]	[22]
Vemurafenib	DM62UG5	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Vemurafenib.	Melanoma [2C30]	[22]
LGX818	DMNQXV8	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and LGX818.	Melanoma [2C30]	[22]
Panobinostat	DM58WKG	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Panobinostat.	Multiple myeloma [2A83]	[22]
Siponimod	DM2R86O	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Siponimod.	Multiple sclerosis [8A40]	[22]
Fingolimod	DM5JVAN	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Fingolimod.	Multiple sclerosis [8A40]	[22]
Ozanimod	DMT6AM2	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Ozanimod.	Multiple sclerosis [8A40]	[22]
Romidepsin	DMT5GNL	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Romidepsin.	Mycosis fungoides [2B01]	[22]
Nilotinib	DM7HXWT	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Nilotinib.	Myeloproliferative neoplasm [2A20]	[22]
Dasatinib	DMJV2EK	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Dasatinib.	Myeloproliferative neoplasm [2A20]	[22]
Promethazine	DM6I5GR	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Promethazine.	Nausea/vomiting [MD90]	[22]
Entrectinib	DMMPTLH	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Entrectinib.	Non-small cell lung cancer [2C25]	[22]
Levomethadyl Acetate	DM06HG5	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Levomethadyl Acetate.	Opioid use disorder [6C43]	[22]
Lofexidine	DM1WXA6	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Lofexidine.	Opioid use disorder [6C43]	[22]
Rucaparib	DM9PVX8	Moderate	Decreased metabolism of Sulfamethoxazole caused by Rucaparib mediated inhibition of CYP450 enzyme.	Ovarian cancer [2C73]	[40]
Triclabendazole	DMPWGBR	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Triclabendazole.	Parasitic worm infestation [1F90]	[22]
Pimavanserin	DMR7IVC	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Pimavanserin.	Parkinsonism [8A00]	[22]
Macimorelin	DMQYJIR	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Macimorelin.	Pituitary gland disorder [5A60-5A61]	[22]
Lefamulin	DME6G97	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Lefamulin.	Pneumonia [CA40]	[22]
Lonafarnib	DMGM2Z6	Moderate	Decreased metabolism of Sulfamethoxazole caused by Lonafarnib mediated inhibition of CYP450 enzyme.	Premature ageing appearance [LD2B]	[41]
Degarelix	DM3O8QY	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Degarelix.	Prostate cancer [2C82]	[22]
ABIRATERONE	DM8V75C	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and ABIRATERONE.	Prostate cancer [2C82]	[22]
Enzalutamide	DMGL19D	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Enzalutamide.	Prostate cancer [2C82]	[22]
Relugolix	DMK7IWL	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Relugolix.	Prostate cancer [2C82]	[22]
Bicalutamide	DMZMSPF	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Bicalutamide.	Prostate cancer [2C82]	[22]
Levomepromazine	DMIKFEL	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Levomepromazine.	Psychotic disorder [6A20-6A25]	[22]
Gatifloxacin	DMSL679	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Gatifloxacin.	Respiratory infection [CA07-CA4Z]	[22]
Quetiapine	DM1N62C	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Quetiapine.	Schizophrenia [6A20]	[22]
Aripiprazole	DM3NUMH	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Aripiprazole.	Schizophrenia [6A20]	[22]
Iloperidone	DM6AUFY	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Iloperidone.	Schizophrenia [6A20]	[22]
Paliperidone	DM7NPJS	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Paliperidone.	Schizophrenia [6A20]	[22]
Amisulpride	DMSJVAM	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Amisulpride.	Schizophrenia [6A20]	[22]
Asenapine	DMSQZE2	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Asenapine.	Schizophrenia [6A20]	[22]
Pimozide	DMW83TP	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Pimozide.	Schizophrenia [6A20]	[22]
Trabectedin	DMG3Y89	Moderate	Increased risk of hepatotoxicity by the combination of Sulfamethoxazole and Trabectedin.	Solid tumour/cancer [2A00-2F9Z]	[32]
LEE011	DMMX75K	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and LEE011.	Solid tumour/cancer [2A00-2F9Z]	[22]
Vandetanib	DMRICNP	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Vandetanib.	Solid tumour/cancer [2A00-2F9Z]	[22]
Triptorelin	DMTK4LS	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Triptorelin.	Solid tumour/cancer [2A00-2F9Z]	[22]
Pitolisant	DM8RFNJ	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Pitolisant.	Somnolence [MG42]	[22]
Telavancin	DM58VQX	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Telavancin.	Staphylococcal/streptococcal disease [1B5Y]	[22]
Lenvatinib	DMB1IU4	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Lenvatinib.	Thyroid cancer [2D10]	[22]
Cabozantinib	DMIYDT4	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Cabozantinib.	Thyroid cancer [2D10]	[22]
Tolbutamide	DM02AWV	Moderate	Increased risk of hypoglycemia by the combination of Sulfamethoxazole and Tolbutamide.	Type 2 diabetes mellitus [5A11]	[42]
Insulin-detemir	DMOA4VW	Moderate	Increased risk of hypoglycemia by the combination of Sulfamethoxazole and Insulin-detemir.	Type-1/2 diabete [5A10-5A11]	[24]
Insulin degludec	DMPL395	Moderate	Increased risk of hypoglycemia by the combination of Sulfamethoxazole and Insulin degludec.	Type-1/2 diabete [5A10-5A11]	[24]
Plazomicin	DMKMBES	Moderate	Increased risk of nephrotoxicity by the combination of Sulfamethoxazole and Plazomicin.	Urinary tract infection [GC08]	[23]
Trimeprazine	DMEMV9D	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Trimeprazine.	Vasomotor/allergic rhinitis [CA08]	[22]
Procainamide	DMNMXR8	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Procainamide.	Ventricular tachyarrhythmia [BC71]	[22]
Propafenone	DMPIBJK	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Propafenone.	Ventricular tachyarrhythmia [BC71]	[22]
Flecainide	DMSQDLE	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Flecainide.	Ventricular tachyarrhythmia [BC71]	[22]
Amiodarone	DMUTEX3	Minor	Increased risk of prolong QT interval by the combination of Sulfamethoxazole and Amiodarone.	Ventricular tachyarrhythmia [BC71]	[43]

References

• [1] Sulfamethoxazole FDA Label
• [2] Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health & Human Services. 2015
• [3] Opportunities and challenges in antiparasitic drug discovery. Nat Rev Drug Discov. 2005 Sep;4(9):727-40.
• [4] Pharmacological properties of oral antibiotics for the treatment of uncomplicated urinary tract infections. J Chemother. 2017 Dec;29(sup1):10-18. doi: 10.1080/1120009X.2017.1380357.
• [5] BDDCS applied to over 900 drugs
• [6] van der Ven AJ, Mantel MA, Vree TB, Koopmans PP, van der Meer JW: Formation and elimination of sulphamethoxazole hydroxylamine after oral administration of sulphamethoxazole. Br J Clin Pharmacol. 1994 Aug;38(2):147-50. doi: 10.1111/j.1365-2125.1994.tb04339.x.
• [7] FDA Approved Drug Products: Bactrim (sulfamethoxazole/trimethoprim) oral tablets
• [8] Estimating the safe starting dose in phase I clinical trials and no observed effect level based on QSAR modeling of the human maximum recommended daily dose
• [9] Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 1352 Drug Compounds
• [10] ADReCS-Target: target profiles for aiding drug safety research and application. Nucleic Acids Res. 2018 Jan 4;46(D1):D911-D917. doi: 10.1093/nar/gkx899.
• [11] In vitro activities of novel antifolate drug combinations against Plasmodium falciparum and human granulocyte CFUs. Antimicrob Agents Chemother. 1995 Apr;39(4):948-52.
• [12] The effect of cimetidine on the formation of sulfamethoxazole hydroxylamine in patients with human immunodeficiency virus. J Clin Pharmacol. 1998 May;38(5):463-6.
• [13] Reduction of sulfamethoxazole and dapsone hydroxylamines by a microsomal enzyme system purified from pig liver and pig and human liver microsomes. Life Sci. 2005 May 27;77(2):205-19.
• [14] Sulfamethoxazole and its metabolite nitroso sulfamethoxazole stimulate dendritic cell costimulatory signaling. J Immunol. 2007 May 1;178(9):5533-42.
• [15] Substrates, inducers, inhibitors and structure-activity relationships of human Cytochrome P450 2C9 and implications in drug development. Curr Med Chem. 2009;16(27):3480-675.
• [16] Crystallization and preliminary X-ray characterization of arylamine N-acetyltransferase C (BanatC) from Bacillus anthracis. Acta Crystallogr Sect F Struct Biol Cryst Commun. 2007 Oct 1;63(Pt 10):862-4.
• [17] Analysis of nucleotide diversity of NAT2 coding region reveals homogeneity across Native American populations and high intra-population diversity. Pharmacogenomics J. 2007 Apr;7(2):144-52. doi: 10.1038/sj.tpj.6500407. Epub 2006 Jul 18.
• [18] Early identification of clinically relevant drug interactions with the human bile salt export pump (BSEP/ABCB11). Toxicol Sci. 2013 Dec;136(2):328-43.
• [19] Systems pharmacological analysis of drugs inducing stevens-johnson syndrome and toxic epidermal necrolysis. Chem Res Toxicol. 2015 May 18;28(5):927-34. doi: 10.1021/tx5005248. Epub 2015 Apr 3.
• [20] Evaluation of the sensitizing potential of antibiotics in vitro using the human cell lines THP-1 and MUTZ-LC and primary monocyte-derived dendritic cells. Toxicol Appl Pharmacol. 2012 Aug 1;262(3):283-92.
• [21] A toxicogenomic approach to drug-induced phospholipidosis: analysis of its induction mechanism and establishment of a novel in vitro screening system. Toxicol Sci. 2005 Feb;83(2):282-92.
• [22] Canadian Pharmacists Association.
• [23] Cerner Multum, Inc. "Australian Product Information.".
• [24] Abad S, Moachon L, Blanche P, Bavoux F, Sicard D, Salmon-Ceron D "Possible interaction between glicazide, fluconazole and sulfamethoxazole resulting in severe hypoglycaemia." Br J Clin Pharmacol 52 (2001): 456-7. [PMID: 11678792]
• [25] Asplund K, Wiholm BE, Lithner F "Glibenclamide-associated hypoglycaemia: a report on 57 cases." Diabetologia 24 (1983): 412-7. [PMID: 6411511]
• [26] Product Information. Sirturo (bedaquiline). Janssen Pharmaceuticals, Titusville, NJ.
• [27] Product Information. Turalio (pexidartinib). Daiichi Sankyo, Inc., Parsippany, NJ.
• [28] Fuhr U, Maier-Bruggemann A, Blume H, et al. "Grapefruit juice increases oral nimodipine bioavailability." Int J Clin Pharmacol Ther 36 (1998): 126-32. [PMID: 9562227]
• [29] Hermida J, Zarza J, Alberca I, et al. "Differential effects of 2C9*3 and 2C9*2 variants of cytochrome P-450 CYP2C9 on sensitivity to acenocoumarol." Blood 99 (2002): 4237-9. [PMID: 12010835]
• [30] Product Information. CellCept (mycophenolate mofetil). Roche Laboratories, Nutley, NJ.
• [31] Product Information. Kalydeco (ivacaftor). Vertex Pharmaceuticals, Cambridge, MA.
• [32] Cerner Multum, Inc. "UK Summary of Product Characteristics.".
• [33] Product Information. Adcetris (brentuximab vedotin). Seattle Genetics Inc, Bothell, WA.
• [34] Product Information. Intelence (etravirine). Ortho Biotech Inc, Bridgewater, NJ.
• [35] Product Information. Kynamro (mipomersen). Genzyme Corporation, Cambridge, MA.
• [36] Product Information. Juxtapid (lomitapide). Aegerion Pharmaceuticals Inc, Cambridge, MA.
• [37] Product Information. Accolate (zafirlukast). Zeneca Pharmaceuticals, Wilmington, DE.
• [38] Al-Nawakil C, Willems L, Mauprivez C, et.al "Successful treatment of l-asparaginase-induced severe acute hepatotoxicity using mitochondrial cofactors." Leuk Lymphoma 55 (2014): 1670-4. [PMID: 24090500]
• [39] Product Information. Zydelig (idelalisib). Gilead Sciences, Foster City, CA.
• [40] EMA. European Medicines Agency. European Union "EMA - List of medicines under additional monitoring.".
• [41] Product Information. Zokinvy (lonafarnib). Eiger BioPharmaceuticals, Palo Alto, CA.
• [42] Christensen LK, Hansen JM, Kristensen M "Sulphaphenazole-induced hypoglycemic attacks in tolbutamide-treated diabetics." Lancet 2 (1963): 1298-301. [PMID: 14071924]
• [43] Crouch MA, Limon L, Cassano AT "Clinical relevance and management of drug-related QT interval prolongation." Pharmacotherapy 23 (2003): 881-908. [PMID: 12885102]